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Supportive Care in Cancer
Published in: Supportive Care in Cancer 3/2013

01-03-2013 | Original Article

Continuous enteral administration can overcome the limited capacity to absorb glucose in rats with methotrexate-induced gastrointestinal mucositis

Authors: Margot Fijlstra, Edmond H. H. M. Rings, Theo H. van Dijk, Torsten Plösch, Henkjan J. Verkade, Wim J. E. Tissing

Published in: Supportive Care in Cancer | Issue 3/2013

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Abstract

Background

Patients with chemotherapy-induced gastrointestinal mucositis often suffer from weight loss. It is not well known how to enterally feed mucositis patients, potentially experiencing malabsorption. Recently, we showed in a rat model of methotrexate (MTX)-induced mucositis that intestinal absorption of glucose in trace amounts is still intact. We now determined the quantitative capacity to absorb glucose in rats with mucositis, relative to controls.

Methods

We administered a physiologically relevant amount of [1-13C]glucose-enriched glucose (meal size) as a bolus by oral gavage (2 g/kg once) or continuously by intraduodenal infusion (±1.9 g/(kg·h) for 5 h) to rats with MTX-induced mucositis and controls. Blood [1-13C]glucose concentrations were determined during the experimental period. To calculate the quantitative absorptive capacity, Steele’s one-compartment model, including simultaneous intravenous infusion of [6,6-2H2]glucose, was used. After the experiment, jejunal histology and plasma citrulline concentrations were assessed.

Results

MTX-induced mucositis was confirmed by a reduction in villus length and plasma citrulline (both −57 %, relative to controls, P < 0.01). When glucose was administered as a bolus, MTX-treated rats only absorbed 15 % of administered glucose, compared with 85 % in controls (medians, P < 0.01). Upon continuous intraduodenal glucose infusion, the median absorptive capacity for glucose in MTX-treated rats did not differ from controls (80 versus 93 % of administered glucose respectively, P = 0.06). However, glucose absorption differed substantially between individual MTX-treated rats (range, 21–95 %), which correlated poorly with villus length (rho = 0.54, P = 0.030) and plasma citrulline (rho = 0.56, P = 0.024).

Conclusion

Continuous enteral administration can almost completely overcome the reduced absorptive capacity for glucose in rats with mucositis.
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Metadata
Title
Continuous enteral administration can overcome the limited capacity to absorb glucose in rats with methotrexate-induced gastrointestinal mucositis
Authors
Margot Fijlstra
Edmond H. H. M. Rings
Theo H. van Dijk
Torsten Plösch
Henkjan J. Verkade
Wim J. E. Tissing
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 3/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-012-1597-2

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